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Anti-asthmatic drugs and dosage forms in children: a cross-sectional study
Eric Schirm1, Hilde Tobi, Henkjan Gebben
1Department of Social Pharmacy and Pharmacoepidemiology, Groningen University Institute for Drug Exploration (GUIDE), Groningen, The Netherlands.
Insights
This study on pediatric asthma medication in the Netherlands found that inhaled beta 2-agonists and inhaled corticosteroids are common. Drug choices and delivery methods generally align with guidelines, though some youngest children received deptropine, and preventive treatments were frequent without beta 2-agonists.
Area of Science:
- Pediatric Pulmonology
- Pharmacology
- Public Health
Background:
- Asthma management in children requires age-appropriate drug selection and dosage forms.
- Understanding current prescribing patterns is crucial for optimizing pediatric asthma care.
Purpose of the Study:
- To analyze the selection of anti-asthmatic drugs and their dosage forms in children across different age groups.
- To compare prescribing practices with established asthma treatment guidelines for pediatric populations.
Main Methods:
- A cross-sectional study utilized computerized pharmacy dispensing records from 1999 in the northern Netherlands.
- Children aged 0-16 years were included and categorized into four age groups: 0-1, 2-5, 6-11, and 12-16 years.
Main Results:
- Inhaled beta 2-agonists (59%) and inhaled corticosteroids (58%) were the most frequently used anti-asthmatic drugs across all pediatric age groups.
- A shift from oral dosage forms to aerosol inhalers was observed up to age four, followed by the increasing use of dry powder inhalers from age four onwards.
- Cromones were infrequently prescribed, and deptropine use was notably high in the youngest age cohort.
Conclusions:
- Prescribing patterns for anti-asthmatic drugs and dosage forms largely align with pediatric asthma treatment guidelines.
- High utilization of preventive treatments without concurrent use of beta 2-agonists raises concerns regarding potential overtreatment in some pediatric asthma cases.
Objective:
To describe the choice of drugs as well as the dosage forms of anti-asthmatic drugs in children with regard to different age groups.
Methods:
Cross-sectional study based on computerized pharmacy dispensing records of 1999 for children aged 0-16 years in the north of the Netherlands. All children were selected and divided in the following age groups: 0-1, 2-5, 6-11 and 12-16-year-olds.
Results:
Inhaled beta 2-agonists and inhaled corticosteroids were the most widely used anti-asthmatic drugs in all age groups (respectively 59 and 58 users per 100 anti-asthmatic using 0-16 year-olds). Cromones were rarely used. Up to four years of age the use of treatment with aerosol inhalers increased simultaneously with a decrease of oral dosage forms. The use of dry powder inhalers started at the age of approximately 4 years old and increased to about 85% of the users at the age of 11, with the strongest increase around the age of 6 and 7.
Conclusion:
The choice of drugs and dosage forms corresponds with what might be expected based on guidelines for the treatment of asthma in children, except for the high use of deptropine in the youngest age group. Anti-asthmatic drugs for preventive treatment are used so frequently without beta 2-agonists that questions about possible overtreatment need to be raised.